To get conservatives such as Lee, Cruz and Rubio on board, the reconciliation bill may have to be changed to dismantle other controversial parts of Obamacare that are untouched in the current bill. Those provisions include the Medicaid expansion and the subsidies provided to millions of consumers who purchase insurance through the Obamacare exchanges.

The current bill that passed the House continues Medicaid expansion. Republicans from marginal districts want to keep Medicaid expansion and subsidies for insurance, they just don’t want to pay for it.

Bevin said his intent is not to cut people off but to customize Medicaid to Kentucky through a waiver – known as a “1115 Medicaid demonstration waiver” – of federal rules on eligibility and coverage. Bevin has pointed to Indiana’s model as an example of the direction he wants Kentucky to head. Medicaid recipients there pay either premiums or co-pays, sometimes both. Ashley Spalding, research and policy associate for the Kentucky Center for Economic Policy, said that would tamp down access to health care.

Kentucky is highly likely to continue Medicaid expansion albeit via a convoluted, more expensive and less comprehensive waiver instead of straight-up expansion that it currently has. The Governor elect first made his name as being a full repeal without replacing Tea Partier reactionary, but he is backing off to expanding Medicaid under PPACA without calling it an Obamacare Medicaid expansion.

The fight over Medicaid expansion has become one of this decade’s great partisan divides in Alabama. Under the ACA, states were originally intended to expand Medicaid to people with income levels up to 138 percent of the federal poverty level, providing an out for people too poor to meet the law’s requirement to buy health insurance. But Gov. Robert Bentley, like many red-state governors, declined to expand the program, citing opposition to Obamacare and concern about the state’s ability to pay for expansion.

That wall of opposition may be crumbling. As recently as Thursday, Bentley told reporters that he was considering expansion, though he had yet to make a final decision on the issue…

A blue-ribbon task force, assembled by the governor earlier this year to study solutions to the state’s most pressing health issues, may vote this week on a resolution recommending something similar.

“We are considering a recommendation that the governor expand coverage to include as many people as possible,” said Ronald Franks, chairman of the Alabama Health Care Improvement Task Force. Franks said wider health care coverage would likely help the state deal with widespread issues such as diabetes.

Alabama has not submitted a waiver nor has it outlined a waiver application, but given that a major and successful Republican political leader’s spokeswoman did not issue a vehement and clear denial.

These type of discussions and decisions are how programs get entrenched. Opponents are making operational peace with reality as it is instead of how they wish it to be.

The NYT has the latest on the ongoing kerfluffle between DNC Chair Debbie Wasserman Schultz and other party members over the number of debates:

R.T. Rybak, the former mayor of Minneapolis and a vice chairman of the Democratic National Committee, on Thursday accused the party’s leader, Representative Debbie Wasserman Schultz, of making “flat-out not true” statements about another top party officer, questioned her political skills and said he had “serious questions” about her suitability for the job.

The broadside from Mr. Rybak, which came in an interview late Thursday afternoon, followed weeks of internal party dissension over the number and timing of the presidential debates it has scheduled, capped by an acrimonious public dispute over whether Ms. Wasserman Schultz had punitively barred a Democratic vice chairwoman, Tulsi Gabbard, from the first debate, held on Tuesday in Las Vegas.

The comments from Mr. Rybak, who was interested in replacing Ms. Wasserman Schultz in 2013 and who was the favored choice of some of President Obama’s aides, were notable in part because he is not known as a public complainer. But by the evening’s end, most of the other party officers issued statements strongly supporting Ms. Wasserman Schultz and calling for an end to the public rancor.

A lot of Democrats seem to dislike DWS and blame her for the party’s lousy showing in midterm elections. I don’t — I blame the idiot voters who can’t get excited about politics unless there’s the grand reality show drama of a presidential election to make them all tingly. It’s not DWS’s fault that these short-sighted mopes stay home and allow their city councils, school boards and state legislatures to be taken over by local Sarah Palin knock-offs.

That said, DWS is annoyingly chummy with the wingnut delegation from South Florida — to the point where it’s reasonable to wonder if she’d like to see them replaced with Democrats — and hasn’t exactly distinguished herself in her current gig. At the very least, a competent chair should be able to keep a lid on infighting such as the type the NYT is covering.

Regarding the number of debates, what do you think? DWS is accused of limiting it to six to stack the deck for HRC, and maybe that’s true; I honestly don’t know. But do we really need a gazillion debates? If no one can pick Martin O’Malley out of a line-up after #6, I’m not sure further debates would help.

Absent an even more public and open revolt, it seems unlikely the party will get rid of DWS just as an important election is heating up. But maybe President Hillary or President Bernie can appoint her as HUD Secretary or something so she’ll go away and someone more effective can take on the role. Not sure who that would be, but the chair pictured at left above might be a good candidate.

https://www.balloon-juice.com/wp-content/uploads/2015/11/balloon_juice_header_logo_grey.jpg00Betty Crackerhttps://www.balloon-juice.com/wp-content/uploads/2015/11/balloon_juice_header_logo_grey.jpgBetty Cracker2015-10-16 15:25:592015-10-16 15:27:10Time to Show the Chair the Door?

ObamaCare is a Great Mess: A View of the Affordable Care Act Without Partisan Blinders & How to Fix It. By Jed Graham. Amazon, June 2015

Mr. Graham writes that there are a couple major problems with the ACA going forward. The first is that the subsidies are not rich enough to be attractive to people who make more than 200% FPL. Secondly, the subsidies are only sufficient to cover Bronze plans with big deductibles instead of cost-sharing Silver plans with low deductibles but 15% higher premiums. Thirdly, the subsidies end too soon. While finally the plans are too costly for young people which is leading to a sicker and older risk pool than projected.

Andrew has done a good job of dismantling the second point as he has been pointing out that the vast majority of people who are eligible for cost-sharing Silver plans are buying those plans as the deductibles are far more reasonable than slightly cheaper Bronze plans.

However, the other problems have a very simple solution. Shovelling money at them. The subsidy formula could theoretically be tweaked so that slope upwards of the personal contribution at a given income level is far less, the base line plans could be reset so a Silver is 75% actuarially value where the additional actuarial value is paid for by subsidy dollars instead of individual dollars. The subsidy formula could be easily tweaked so that no family pays more than X% of their income for a QHP without regard to the income level so there is no income cliff/work disincentive at 399.99% FPL.

All of those are fairly simple tweaks that are not disruptive to the fundamental delivery of health care and health insurance to the greater population. And these are all problems where throwing money at the problem is a valid and viable solution.

We did not get these policy tweaks in PPACA because the Democrats, and more importantly, the marginal decision makers in the Democratic caucs were petrified of writing a bill with a “bad” CBO score. There was a line of thought that a “responsible” and “small” bill would help preserve a majority or at least more of the marginal district Democrats. Going bigger would have produced a better bill ( and if the bill contained more cash going out the door in 2012/2013, a slightly better economy).

In reality, Democrats who represented significantly Republican leaning districts as the country became more polarized had to count on two things to stay in office. The first was that any particular opponent was a kid-diddling goat fucker. The second was a good economy with significant wage gains. A good CBO score on a polarizing bill is about the ninety-ninth ranking aid to re-election. A “responsible” bill pandered to elite consensus without actually getting any additional people to vote for “responsible” Democrats.

Alaska will become the 30th state to accept Obamacare’s optional Medicaid expansion, after Gov. Bill Walker (I) announced on Thursday that he will use his executive power to bypass the GOP-controlled legislature and implement the policy on his own.

Walker — a former Republican who has since become an Independent — has been advocating for Medicaid expansion for over a year. Implementing this particular Obamacare provision, which was ruled optional by the Supreme Court in 2012, would extend health coverage to an estimated 40,000 low-income residents in his state.

Decent chance there will be a court fight on the expansion, but establishing facts on the ground that this is what a civilized state does (especially when someone else is paying either the entire bill or the vast majority of it), and more importantly getting the hospital groups on board and used to the revenue will start entrenching the program.

And here is the Republican response to Medicaid expansion in Alaska:

“I think in this time, in these lean years, it’s time for communities to pull together, it’s time for churches to step up, it’s time to help give a hand to each other as individuals. We can be kind as people. It’s not government’s place to be kind,” State Rep. Shelley Hughes (R) said in reference to uninsured Alaskans when the House voted down Medicaid expansion in March.

Counting on churches, private charity, bake sales and magical unicorns flying out of a yeti’s ass has been the working poor health insurance plan for years. That has not worked, but let’s try it again and clap louder. Asshole.

Today’s Supreme Court decision on Obamacare makes the law about as settled as it can be given that congress and most statehouses are run by hairspray-huffing shitweasels who occupy an alternative dimension where “flush billions down the toilet” = “fiscal conservatism.”

Shortly after the Supreme Court decision today, our shitweasel governor here in FL announced that he’s dropping a lawsuit he filed against the Obama administration in an attempt to extract a $2 billion handout via a low-income care program — after declining to expand Medicaid to the 800K Floridians who would qualify under Obamacare.

TALLAHASSEE — Florida Gov. Rick Scott is dropping a lawsuit against the Obama administration after reaching an agreement over federal hospital funds.

State and federal health officials reached an agreement in principle earlier this week to continue funding Florida’s hospital low-income pool for two more years, but at a lower cost. Florida will receive $1 billion this year — about half of what the state had been receiving — and $600 million next year. In a statement Thursday, Scott said his lawsuit was essential to getting the funds extended.

Scott’s lawsuit accused the federal government of tying the funds to whether or not the state expanded Medicaid.

The Obama administration and the Florida Senate wanted to expand Medicaid to roughly 800,000 Floridians. But Scott and Florida House Republicans opposed to taking money tied to so-called Obamacare.

Yes, you read that right: These morons turned down $6 billion or so annually because it has Obamacare cooties but were prepared to go to court to shake the feds down for a relatively paltry $2 billion. As a result of this super-genius bluffing strategy, Scott got $1 billion this year and $600 million next year, and he deems it a victory for fiscal prudence.

As far as I know, Scott hasn’t yet outlined his double-secret negotiating strategy for next time the money dries up, which will be 2017. God willing, President Hillary will send him home pants-less with a $400K mortgage note on Stately Scott Manor. This would all be laughable if people weren’t literally dying because of Scott & Co.’s pigheadedness.

ETA: Open thread for anyone who wants to use it for one. We’ve had a lot of Obamacare threads today. In other news, the AP says Chris Christie is going to announce a run on Tuesday. They’re gonna need a bigger clown car (and no, that’s not a fat joke — there are just so MANY clowns!).

Early this morning, I was doing some research on the endurance of corporate culture, studying how sometimes the spirit of a smaller, acquired firm can permeate the larger, acquiring organization. It’s not unusual for a big behemoth to acquire a scrappy smaller company solely for the purpose of infusing the moribund giant with fresh blood, and when the companies’ interests align, it can create an unstoppable marketplace force…for a while.

With that dynamic still on my mind, I moseyed over to Booman’s place and read a post that hit upon something that has been bothering me about the focus on the rebel flag in the wake of the domestic terrorist massacre in Charleston:

But the focus on the Confederate Flag can have an unfortunate side effect. What, after all, does that flag mean when it doesn’t simply mean white supremacy?

It’s meaning in those cases in nearly identical to the meaning of the modern conservative movement. It’s about disunion, and hostility to the federal government, and state’s rights. It’s anti-East Coast Establishment and anti-immigrant. It’s about an idealized and false past and preserving outworn and intolerant ideas. It’s about a perverse version of a highly provincial and particularized version of (predominantly) Protestant Christianity that has evolved to serve the interests of power elites in the South. It’s about an aggrieved sense of false persecution where white men are playing on the hardest difficulty setting rather than the easiest, and white Christians are as threatened as black Muslims and gays and Jews.

“Those blacks are raping our women and they have to go.”

That’s what the Confederate Flag is all about, but it’s also the basic message of Fox News and the whole Republican Party since the moment that Richard Nixon promised us law and order.

But it’s not black people who have to go.

It’s this whole Last Cause bullshit mentality that fuels our nation’s politics and lines the pockets of Ted Cruz just as surely as it has been lining the pockets of Walmart executives.

Today, maybe the governor down there had an epiphany. Maybe this massacre was the last straw. But, tomorrow, we’ll all be right back where we began with Congress acting like an occupying Confederate Army.

If we solve a symbolic problem and leave the rest untouched, then what will really change?

You can’t bury the Confederate Flag without, at the same time, burying the Conservative Movement.

Let’s get on with it.

He’s right. For many white people, the rebel flag represented moldy old myths about the antebellum South. But think about how nicely that mythology dovetailed with the lies about the pre-Civil Rights era that paleocons like Pat Buchanan tell themselves.

Like a moribund corporation, the GOP acquired Confederate culture with the Southern strategy, harnessing the racism in the South and its echo nationwide to build the present day Republican Party. That’s why Ronald Reagan launched his presidential campaign in Philadelphia, Mississippi. That’s why an always-wrong, New York City-born legacy hire who is relentlessly eager to send other people’s kids off to die in glorious causes is tweeting nonsense that his ancestors would find…puzzling:

The Left’s 21st century agenda: expunging every trace of respect, recognition or acknowledgment of Americans who fought for the Confederacy.

So, the rebel flag should come down in South Carolina and every other state capitol in the former Confederacy, and with surprising (to me) swiftness, it looks like it will. That will be more than a symbolic victory; it will be the partial righting of a very old wrong.

But there’s a danger in “otherizing” the South in this context. It’s not wrong to condemn its blinkered myth-making and prideful backwardness, but there’s a hazard in moral preening within and outside of Dixie, a risk of declaring a tidy victory when the dinosaurs in the state capitols of the former Confederacy finally sink into the tarpit they’ve thrashed in for 150 years.

The risk is that we’ll lose focus on the modern day “Congress acting like an occupying Confederate Army,” as Booman put it. At its core, the Southern strategy was an attempt to roll back progress by hitching the anti-New Dealers’ star to the creaky old Confederate wagon. Its organizers weren’t all or even mostly slack-jawed yokels waving rebel flags. They included a fiery libertarian business man from Phoenix, a glib B-movie pitchman who hailed from Northern Illinois and a twitchy, paranoid Quaker from California.

To achieve true victory, we have to finally drive a stake through the heart of the Southern strategy, not just the Confederacy. So let’s make expunging the rebel flag from the public square the opening salvo in a larger battle to take our country back. Yes, that’s right, TAKE OUR COUNTRY BACK. With no lies and decaying myths about what that means. The flag that represents it isn’t spotless. Its founding was rooted in slavery, genocide and the oppression of women. But unlike its dying counterpart, this flag is worth saving.

I’m sure most of us have many reasons to fervently hope that whichever hairball the GOP horks up for the presidential nomination in 2016 is soundly rejected by voters. But for me, not least on that long list is the hope that a third straight drubbing at the polls might prompt the Republicans to do some serious soul-searching.

Three presidential losses in a row prompted many Democrats to sell out the New Deal and adopt the corporate-friendly DLC bullshit line. Maybe Bill Clinton had to ride the Third Way slide to two-term victory — that’s debatable. We didn’t have to be happy about it, but it was better than another Poppy Bush term or a Bob Dole presidency.

Anyhoo, in this morning’s Wake Up Sheeple thread, I mentioned that losing three presidential races in a row (please FSM, let it be so!) would be a big fucking deal for Republicans. Not everyone agreed. Valued commenter JustRuss made some excellent points in the following reply:

To a party that cared about governing, sure. But “the party” is mostly the money, and they just want the government to stay the hell out of their way. And with the IRS and EPA being starved, TPP and other trade deals in the hopper, Citizen’s United, fracking bans being overturned left and right, they’re doing fine. Sure, it would be nice to have a Bush in the White House, but they’re getting most of what they want regardless. Having a Democrat in the White House gives them someone to blame when things go sideways and is a great focus for the rage their constituents are addicted to.

I’m not saying you’re wrong, but I’m not convinced you’re right either.

Those are all great points, and if the GOP could ride the current status quo forever, I’d agree that they could just disregard presidential losses indefinitely. But I don’t think they could maintain the status quo in the face of a mounting string of losses at the presidential level, even if they managed to keep winning in mid-term and state-level elections for a while.

Presidential elections in this country (maybe everywhere else too — I don’t know) are about a lot more than a transfer of specific powers; they’ve morphed into an absurd, trillion-dollar reality show spectacle, with the thrill of victory and the agony of defeat. Politics is a team sport.

And people don’t like losing over and over. If it keeps happening, they swear off the sport or find another team. Oh sure, some diehards will stand with their shitty loser team through thick and thin (maybe 27% or so). But the fan base won’t have a healthy growth rate, and the less committed will slink off to sulk at home or maybe even join another bandwagon.